"porn and sex addictions are probably not addictions"

http://www.thedailybeast.com/articles/2015/06/26/your-porn-addiction-isn-t-real.html

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06.26.155:15 AM ET

Your Porn Addiction Isn’t Real

The brains of those ‘addicted’ to porn bear no neurological resemblance to those of other well-documented addictions while watching it, says a new study. Why the word needs to change.

The last time neuroscientists Nicole Prause (Liberos LLC at UCLA) and Vaughn Steele (Mind Research Network) published on porn addiction, they received six legal threats, several calls for a retraction, and anonymous emails telling them to kill themselves.

Their controversial claim: “porn addiction” isn’t actually an addiction, at least in the sense that it does not neurologically behave like other well-documented addictions.

For therapists that treat porn on an addiction model and for religious groups like Focus on the Family that are invested in maintaining a concept of “porn addiction,” the research undermines the clinical language they used in their approach to the controversial medium. But conclusive evidence for “sex addiction” and “porn addiction” continues to prove elusive. 

Today, Prause, Steele, and their team of researchers are back with a new study, published in the journal Biological Psychology, that only reaffirms their previous findings: “porn addiction” and “sex addiction,” as we understand them, may not be real.

The results were clear: Subjects who reported experiencing problems as a result of their pornography use did not display characteristically addictive brain activity when viewing sexual images.

In what is now the largest neuroscience investigation of porn addiction ever conducted, Prause and a team of UCLA-based researchers asked 122 men and women to answer questions about their use of “visual sexual stimuli” to determine if they experienced problems as a result of their porn usage.

Whether the subjects were “problem users” or not, they were all shown several categories of images—pleasant ones like skydiving photos, neutral ones like portraits, unpleasant ones like mutilated bodies, and, of course, sexual images—while hooked up to an electroencephalogram (EEG), a device that measures electrical activity in the brain.

From this body of data, researchers examined each subject’s late positive potential (LPP), a common measure for the intensity of the brain’s emotional response at a given moment. The results were clear: Subjects who reported experiencing problems as a result of their pornography use did not display characteristically addictive brain activity when viewing sexual images.

As Greg Hajcak, a Stony Brook University researcher on the study, points out, a cocaine addict will experience “increased LLP to cocaine-related pictures”—one of the clearest indicators of psychological addiction.

But even subjects in the study who experienced “major problems” related to their porn usage didn’t display this same LLP pattern when viewing sexual images. In fact, as the researchers note, they “showed decreased brain reactions when shown the sexual images, rather than heightened activity”—the opposite of what one would expect to find in an addict’s brain.

Some self-described “porn addicts” may experience legitimate problems as a result of their habits, the researchers are quick to clarify, but neurologically speaking, they do not appear to have the same relationship to porn as a substance addict has to their drug of choice. In other words, porn and sex addictions are probably not addictions and treating them as such could prove counter-productive.

“This study appears to add to a list of studies that have not been able to identify pathology consistent with substance addiction models,” the authors conclude.

“Labeling a person’s attempt to control urges a ‘sexual addiction’ may interfere with therapy...”

So far, the American Psychiatric Association (APA) has agreed that there is insufficient evidence to support diagnoses for sex and porn addiction. In 2010, the APA rejected the inclusion of “sex addiction” in the Diagnostic and Statistical Manual of Mental Disorders (DSM). A new condition called “hypersexual disorder” was proposed for the DSM-5 but, in 2012, the APA rejected it as well for lack of evidence.
A large study like Prause’s only shores up these previous decisions. But for those who seek the medical authority of an official “sex addiction” diagnosis, this may not be the best news. If possible, Prause and her team would like to avoid the controversy and threats this time around, although that may be impossible given the loaded subject matter.

“Many people have misinterpreted our research as saying that people are faking these problems,” she tells The Daily Beast. “We have never made that claim.”

Prause stresses that therapists should simply be providing treatments that are “supported by research” and that “addiction appears to be the wrong model” for those treatments.

As it stands, several therapy programs, rehab centers, and religious groups continue to treat problems related to sex and pornography using an addiction-based approach. The Catholic-led organization Integrity Restored, for example, considers porn to be addictive, claiming that “[b]rain scans show how the brain of a porn addict is no different than the brain of a drug addict.”

To the contrary, the research of Prause and her team seems to prove that the brain of a porn addict behaves quite differently from the brain of a drug addict.

The Church of Jesus-Christ of Latter-day Saints also runs a notable Addiction Recovery Program that treats “pornography addiction” using a 12-step program. Many other churches and rehab centers—like the famous Promises Treatment Centers frequented by Hollywood celebrities—take a similar approach to porn and sex “addiction” or “compulsivity.”

“Although the Diagnostic and Statistical Manual of Mental Disorders does not yet recognize sexual compulsivity as a disorder, it is a very real and serious problem,” the Promises website maintains.

But unscientifically mislabeling these problems as “addictions,” Prause and team argue, helps no one, especially those who actually do want to change their relationship to porn.

“Labeling a person’s attempt to control urges a ‘sexual addiction’ may interfere with therapy approaches such as Acceptance and Commitment Therapy (ACT) that can reduce distressing sexual behaviors,” said co-author and Idaho State University psychologist Cameron Stanley.

In contrast to an addiction recovery approach—which seeks to end problematic behavior—Prause tells The Daily Beast that an ACT approach might involve “reducing viewing over time, not necessarily eliminating it.”

“ACT also supports finding ways to be comfortable with negative feelings associated with viewing sex films, which ultimately might make a person enjoy lower consumption rates,” she says. 

There has already been preliminary research from Utah State University (PDF) suggesting that ACT could be an effective way to help those who claim to have an “Internet pornography addiction.” In the experiment, researchers treated six men with eight 90-minute sessions of ACT. Three months later, the men had experienced an 85 percent reduction in viewing along with increased quality of life.

Sex and porn “addictions” may not be real but, whatever they are, it’s likely can still be treated. The catch? We might have to stop calling them “addictions” first.

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